Green, Lara E

Green, Lara E is an individual health care provider with primary practice located at 2821 36Th Ave Nw Ste 105 , Norman OK 73072-2471. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Green, Lara E can be contacted via phone (405) 515-2049.

Contact Information

Primary practice address
2821 36Th Ave Nw Ste 105 Norman OK 73072-2471
Phone: (405) 515-2049
Fax: (405) 307-5631
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1235 Oklahoma

Profile Details

NPI number 1558339184
LBN Legal business name Green, Lara E
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Jul 28th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558339184 NPPES
Oklahoma MEDICAID 200063470A

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